Suzuki Takashi, Murata Shin-ichi, Yamaguchi Hiroshi, Shimizu Yoshihiko, Shimizu Michio
Department of Pathology, Saitama Medical University International Medical Center, Saitama, Japan.
Acta Cytol. 2010 Jul-Aug;54(4):605-10. doi: 10.1159/000325186.
Epithelial-myoepithelial carcinoma (EMC) is usually a low grade malignancy with rare mortality. Rare aggressive variants of EMC, dedifferentiated EMC and EMC with myoepithelial anaplasia have been reported.
An 81-year-old man presented with EMC of the parotid gland showing the classical type at the time of initial presentation and a high grade type with myoepithelial anaplasia at recurrence after 10 years. We compared the histologic and cytologic findings of the initial and recurrent tumors. Aspiration cytology of the initial tumor was typical of classical EMC, represented by a biphasic pattern composed of sheetlike and tubular clusters. In contrast, cytologic specimens of the recurrent tumor, which had a focally biphasic pattern similar to that of the initial tumor, also had many isolated or discohesive piled-up clusters of spindle and polygonal cells with nuclear atypia.
The cytologic findings of the recurrent tumor were consistent with a rare variant of EMC with myoepithelial anaplasia. To the best of our knowledge, this is the first report of the cytologic finding of an EMC with myoepithelial anaplasia.
上皮-肌上皮癌（EMC）通常是一种低级别恶性肿瘤，死亡率较低。已有报道称存在EMC的罕见侵袭性变体，即去分化EMC和具有肌上皮间变的EMC。
一名81岁男性，初诊时表现为腮腺EMC的经典类型，10年后复发时为具有肌上皮间变的高级别类型。我们比较了初发肿瘤和复发肿瘤的组织学和细胞学发现。初发肿瘤的细针穿刺细胞学表现为典型的经典EMC，呈由片状和管状细胞簇组成的双相模式。相比之下，复发肿瘤的细胞学标本虽然局部具有与初发肿瘤相似的双相模式，但也有许多孤立的或不粘连的纺锤形和多边形细胞堆积簇，伴有核异型性。
复发肿瘤的细胞学发现与具有肌上皮间变的罕见EMC变体一致。据我们所知，这是关于具有肌上皮间变的EMC细胞学发现的首例报告。
